Ampleur Et déterminants des dépenses catastrophiques de santé: cas des ménages togolais (Magnitude and Determinants of Catastrophic Health Expenditure: Case of Togolese Households)

2019 ◽  
Author(s):  
Yacobou Sanoussi ◽  
MURIEL AMETOGLO
Keyword(s):  
Health Expenditure ◽  
Catastrophic Health Expenditure

scholarly journals Free access to antiretroviral treatment and protection against the risk of catastrophic health expenditure in people living with HIV: evidence from Cameroon

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marwân-al-Qays Bousmah ◽  
Marie Libérée Nishimwe ◽  
Christopher Kuaban ◽  
Sylvie Boyer
Keyword(s):  
Socioeconomic Status ◽  
Health Expenditure ◽  
Antiretroviral Treatment ◽  
Catastrophic Health Expenditure ◽  
Hiv Care ◽  
Free Access ◽  
People Living With Hiv ◽  
Art Policy ◽  
Living With Hiv ◽  
The Impact

Abstract Background To foster access to care and reduce the burden of health expenditures on people living with HIV (PLHIV), several sub-Saharan African countries, including Cameroon, have adopted a policy of removing HIV-related fees, especially for antiretroviral treatment (ART). We investigate the impact of Cameroon’s free antiretroviral treatment (ART) policy, enacted in May 2007, on catastrophic health expenditure (CHE) risk according to socioeconomic status, in PLHIV enrolled in the country’s treatment access program. Methods Based on primary data from two cross-sectional surveys of PLHIV outpatients in 2006–2007 and 2014 (i.e., before and after the policy’s implementation, respectively), we used inverse propensity score weighting to reduce covariate imbalances between participants in both surveys, combined with probit regressions of CHE incidence. The analysis included participants treated with ART in one of the 11 HIV services common to both surveys (n = 1275). Results The free ART policy was associated with a significantly lower risk of CHE only in the poorest PLHIV while no significant effect was found in lower-middle or upper socioeconomic status PLHIV. Unexpectedly, the risk of CHE was higher in those with middle socioeconomic status after the policy’s implementation. Conclusions Our findings suggest that Cameroon’s free ART policy is pro-poor. As it only benefitted PLHIV with the lowest socioeconomic status, increased comprehensive HIV care coverage is needed to substantially reduce the risk of CHE and the associated risk of impoverishment for all PLHIV.

scholarly journals Impact of non-communicable disease multimorbidity on health service use, catastrophic health expenditure and productivity loss in Indonesia: a population-based panel data analysis study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041870
Author(s):  
Tiara Marthias ◽  
Kanya Anindya ◽  
Nawi Ng ◽  
Barbara McPake ◽  
Rifat Atun ◽  
...  
Keyword(s):  
Panel Data ◽  
Health Service ◽  
Low Income ◽  
Health Expenditure ◽  
Service Use ◽  
Financial Burden ◽  
Panel Data Analysis ◽  
Productivity Loss ◽  
Catastrophic Health Expenditure ◽  
Health Service Use

ObjectivesTo examine non-communicable diseases (NCDs) multimorbidity level and its relation to households’ socioeconomic characteristics, health service use, catastrophic health expenditures and productivity loss.DesignThis study used panel data of the Indonesian Family Life Survey conducted in 2007 (Wave 4) and 2014 (Wave 5).SettingThe original sampling frame was based on 13 out of 27 provinces in 1993, representing 83% of the Indonesian population.ParticipantsWe included respondents aged 50 years and above in 2007, excluding those who did not participate in both Waves 4 and 5. The total number of participants in this study are 3678 respondents.Primary outcome measuresWe examined three main outcomes; health service use (outpatient and inpatient care), financial burden (catastrophic health expenditure) and productivity loss (labour participation, days primary activity missed, days confined in bed). We applied multilevel mixed-effects regression models to assess the associations between NCD multimorbidity and outcome variables,ResultsWomen were more likely to have NCD multimorbidity than men and the prevalence of NCD multimorbidity increased with higher socioeconomic status. NCD multimorbidity was associated with a higher number of outpatient visits (compared with those without NCD, incidence rate ratio (IRR) 4.25, 95% CI 3.33 to 5.42 for individuals with >3 NCDs) and inpatient visits (IRR 3.68, 95% CI 2.21 to 6.12 for individuals with >3 NCDs). NCD multimorbidity was also associated with a greater likelihood of experiencing catastrophic health expenditure (for >3 NCDs, adjusted OR (aOR) 1.69, 95% CI 1.02 to 2.81) and lower participation in the labour force (aOR 0.23, 95% CI 0.16 to 0.33) compared with no NCD.ConclusionsNCD multimorbidity is associated with substantial direct and indirect costs to individuals, households and the wider society. Our study highlights the importance of preparing health systems for addressing the burden of multimorbidity in low-income and middle-income countries.

scholarly journals Catastrophic Household Expenditure for Healthcare in Turkey: Clustering Analysis of Categorical Data

Data ◽  
2019 ◽  
Vol 4 (3) ◽  
pp. 112
Author(s):  
Onur Dogan ◽  
Gizem Kaya ◽  
Aycan Kaya ◽  
Hidayet Beyhan
Keyword(s):  
Health Expenditure ◽  
National Income ◽  
Health Spending ◽  
Health Problems ◽  
Catastrophic Health Expenditure ◽  
Catastrophic Expenditure ◽  
Household Level ◽  
Expenditure Rate ◽  
Type Property ◽  
Similarity And Difference

The amount of health expenditure at the household level is one of the most basic indicators of development in countries. In many countries, health expenditure increases relative to national income. If out-of-pocket health spending is higher than the income or too high, this indicates an economical alarm that causes a lower life standard, called catastrophic health expenditure. Catastrophic expenditure may be affected by many factors such as household type, property status, smoking and drinking alcohol habits, being active in sports, and having private health insurance. The study aims to investigate households with respect to catastrophic health expenditure by the clustering method. Clustering enables one to see the main similarity and difference between the groups. The results show that there are significant and interesting differences between the five groups. C4 households earn more but spend less money on health problems by the rate of 3.10% because people who do physical exercises regularly have fewer health problems. A household with a family with one adult, landlord and three people in total (mother or father and two children) in the cluster C5 earns much money and spends large amounts for health expenses than other clusters. C1 households with elementary families with three children, and who do not pay rent although they are not landlords have the highest catastrophic health expenditure. Households in C3 have a rate of 3.83% health expenditure rate on average, which is higher than other clusters. Households in the cluster C2 make the most catastrophic health expenditure.

scholarly journals Catastrophic Expenditure on Medicines: An Analysis Based on The Portuguese Household Budget Survey 2015/2016

2021 ◽  
pp. 1-7
Author(s):  
Carlota QUINTAL ◽  
José LOPES
Keyword(s):  
Health System ◽  
Health Expenditure ◽  
Catastrophic Health Expenditure ◽  
System Evaluation ◽  
Financial Protection ◽  
Catastrophic Expenditure ◽  
Household Budget Survey ◽  
Household Budget

Financial protection is a core dimension of health system evaluation; therefore, several works on catastrophic health expenditure (CHE) have been developed. There are, however, some gaps in the literature; hence, this work aims to look at CHE from a different angle, analysing the money spent by households.

scholarly journals Impact of cigarette price increase on health and financing outcomes in Vietnam

2020 ◽  
Vol 3 ◽  
pp. 1516 ◽  
Author(s):  
Daphne C. Wu ◽  
Prabhat Jha ◽  
Sheila Dutta ◽  
Patricio Marquez
Keyword(s):  
Health Expenditure ◽  
Treatment Cost ◽  
Catastrophic Health Expenditure ◽  
Price Increase ◽  
Income Quintile ◽  
Cigarette Price ◽  
Extreme Poverty ◽  
Excise Tax ◽  
Life Years ◽  
The Impact

Background: Vietnam had about 15 million male smokers in 2015. To reduce adult tobacco use in Vietnam through an increase in the excise tax of cigarettes, we conducted an extended cost-effectiveness analysis to examine the impact of two scenarios of cigarette price increases. Methods: We estimated, across income quintiles, the life-years gained, treatment cost averted, number of men avoiding catastrophic health expenditure and extreme poverty, and additional tax revenue under a 32% and a 62% increase in cigarette price through increased excise tax. We considered only male smokers as they constitute majority of the smokers. We used the average price elasticity of demand for cigarettes in Vietnam of -0.53. Results: Under both scenarios of price increase, men in the poorest quintile would gain about 2.8 times the life-years and avert 2.5 times the treatment cost averted by the richest quintile. With a 32% price increase, about 285,000 men would avoid catastrophic health expenditure; as a result, about 95,000 men, more than half of whom in the poorest quintile, would avoid falling into extreme poverty. In contrast to the distribution of health benefits, the extra revenue generated from men in the richest quintile would be 1.2 times that from the poorest quintile. With a 62% price increase, about 553,000 men would avoid catastrophic health expenditure, and about 183,000 men, more than half of whom in the poorest quintile, would avoid falling into extreme poverty. The extra revenue generated from men in the richest quintile would be 3.8 times that from the poorest quintile. Conclusions: Higher cigarette prices would particularly benefit the poorest income quintile of Vietnamese, in terms of health and financial outcomes. Thus, tobacco taxes are an effective way to improve health and reduce poverty in Vietnam.

scholarly journals Catastrophic health expenditure of chronic diseases: Evidence from Hamadan, Iran

2017 ◽  
Vol 8 (1) ◽  
pp. 99 ◽  
Author(s):  
Sajad Vahedi ◽  
Aziz Rezapour ◽  
FarzadFaraji Khiavi ◽  
Firooz Esmaeilzadeh ◽  
Javad Javan-Noughabi ◽  
...  
Keyword(s):  
Chronic Diseases ◽  
Health Expenditure ◽  
Catastrophic Health Expenditure

scholarly journals Prevalence and factors associated with catastrophic health expenditure among slum and non-slum dwellers undergoing emergency surgery in a metropolitan area of South Western Nigeria

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255354
Author(s):  
Taiwo A. Obembe ◽  
Jonathan Levin ◽  
Sharon Fonn
Keyword(s):  
Health Insurance ◽  
Marital Status ◽  
Emergency Surgery ◽  
Health Expenditure ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Catastrophic Health Expenditure ◽  
Catastrophic Expenditure ◽  
Slum Dwellers ◽  
Multistage Sampling

Background Out of Pocket (OOP) payment continues to persist as the major mode of payment for healthcare in Nigeria despite the introduction of the National Health Insurance Scheme (NHIS). Although the burden of health expenditure has been examined in some populations, the impact of OOP among slum dwellers in Nigeria when undergoing emergencies, is under-researched. This study sought to examine the prevalence, factors and predictors of catastrophic health expenditure amongst selected slum and non-slum communities undergoing emergency surgery in Southwestern Nigeria. Methods The study utilised a descriptive cross-sectional survey design to recruit 450 households through a multistage sampling technique. Data were collected using pre-tested semi-structured questionnaires in 2017. Factors considered for analysis relating to the payer were age, sex, relationship of payer to patient, educational status, marital status, ethnicity, occupation, income and health insurance coverage. Variables factored into analysis for the patient were indication for surgery, grade of hospital, and type of hospital. Households were classified as incurring catastrophic health expenditure (CHE), if their OOP expenditure exceeded 5% of payers’ household budget. Analysis of the data took into account the multistage sampling design. Results Overall, 65.6% (95% CI: 55.6–74.5) of the total population that were admitted for emergency surgery, experienced catastrophic expenditure. The prevalence of catastrophic expenditure at 5% threshold, among the population scheduled for emergency surgeries, was significantly higher for slum dwellers (74.1%) than for non-slum dwellers (47.7%) (F = 8.59; p = 0.019). Multiple logistic regression models revealed the significant independent factors of catastrophic expenditure at the 5% CHE threshold to include setting of the payer (whether slum or non-slum dweller) (p = 0.019), and health insurance coverage of the payer (p = 0.012). Other variables were nonetheless significant in the bivariate analysis were age of the payer (p = 0.017), income (p<0.001) and marital status of the payer (p = 0.022). Conclusion Although catastrophic health expenditure was higher among the slum dwellers, substantial proportions of respondents incurred catastrophic health expenditure irrespective of whether they were slum or non-slum dwellers. Concerted efforts are required to implement protective measures against catastrophic health expenditure in Nigeria that also cater to slum dwellers.

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